___ determination is determination of risk based on the beneficiary on healthcare history and cost of chosen covered serves.

In indemnity programs, what are benefits?

How do indemnity insurance programs limit their payment?

Which of the following is consistent with managed care organizations?

Sort the following.

Which of the following is not associated with indemnity option in POS?

Sort the following

Medicaid is funded by __ and matched and administrated by ___

Match the medicare parts and their services

Which of the following is a plan that let's an employee keep their employer health group plan for 18 months after their employment of if they lose coverage as a dependent of the covered employee?

The ACA is for people

All states have expanded Medicaid plans.

In the ACA, people can't be denied or have increased coverage due to pre-existing medical conditions.

Which of the following has higher out of pocket payments and rewards patients for healthier lifestyles?

Which of the following is funded by employee with pre-tax dollar and must be spent by the end of the year?

Which of the following is funded by the employer or employee to fund higher deductibles?

In health care coverage, there is a shift from __ to __.

___ is a concept where purchasers of healthcare and payers hold the healthcare delivery system at large accountable for both quality and cost of care.

Which of the following sets performance measures by which providers are rated on the quality of services provided?

Which of the following is a tract under MACRA that focuses on providers receiving bonuses versus penalties based on scores from quality of care?

Which of the following is a tract under MACRA that gives a bonus payment if a sufficient number of medicare patients are seen/received?

___ is a healthcare org that seeks to tie provider reimbursements to quality metrics and reductions in total cost of care for an assigned population of patients.

A goal of EHR is to __ care coordination

The goal of the EHR is to implement __ formulary checks

Which of the following is a mechanism to adjust payment to providers based on the severity of illness of patients?

Which of the following is a rating system used by medicare for performance of carriers?

Which of the following is a shared savings program?

Which of the following are domains that rate medicare advantage plans?

The implementation of certified EHR includes the creation of __ which helps healthcare providers to move forward with the goal of value-based care by capturing and reporting data to meet the requirements  of all individual payers.

Which of the following is a performance measurement to facilitate reporting of data to demonstrate payers that the providers are meeting the standards of value-based medicine?

Which of the following involves reimbursement for covered services?

Which of the following requires a PCP and must remain in select panel of providers?

Which of the following is the same as PPO but doesnt have the option to leave the network?

Which of the following is a fixed amount of money per patient per unit time paid in advance to the physician for the delivery of healthcare services?